205例交叉配血试验主侧不相合原因的研究

目的：探讨205例交叉配血试验主侧不相合的原因，为临床解决疑难配血提供参考。方法用盐水法、凝聚胺法和微柱凝胶法进行交叉配血等实验，并对其中交叉配血试验主侧不相合的标本和原因进行检测和分析。结果交叉配血试验主侧阳性205例，有自身抗体为21.46%（44/205），仅有自身抗体为15.61%（32/205）；有同种抗体为76.59%（157/205），仅有同种抗体为70.73%（145/205）；自身抗体合并同种抗体为5.85%（12/205）；其他原因引起为7.80%（16/205），其中高粘滞血症引起的为2.44%（5/205），献血员直接抗球蛋白试验强阳性引起为1.46%（3/205），不明原因引起的为5.37%（11/205）。157例含血型系统抗体，其中29例因血型抗体的特异性无法鉴定，未能确定血型系统，占18.47%（29/157），128例血型系统抗体涉及ABO、Rh、MNSs、Lewis、Duffy、Kidd 6个血型系统，其中Rh血型系统抗体占血型系统抗体的75.16%（118/157），Rh血型系统抗体又以抗-E和抗-c为主，分别为85.59%（101/118）、24.58%（29/118）。结论交叉配血试验主侧不合的主要原因是不规则抗体和自身抗体，其中血型系统抗体以Rh血型系统抗体为主，特别是抗-E抗体和抗-c抗体。

Research on reasons of unmatched blood cross matching test in 205 cases

Objective To evaluate the reasons of 205 cases of unmatched blood cross matching test, to solve the prob-lems of difficult blood matching. Methods Using saline method, polybrene method and micro column gel method for blood cross matching test, to detect and analyze the causes of unmatched major part of blood cross matching test. Results Major part of blood cross matching test was positive in 205 cases, among them, with the autoantibodies was 21.46%（44/205）, only the autoantibodies was 15.61%（32/205）; with the alloantibody was 76.59%（157/205）, only the alloanti-body was 70.73%（145/205）;autoantibodies associated with the alloantibody was 5.85%（12/205）;other causes was 7.80%（16/205）, including hyperlipemia was 2.44%（5/205）, blood donors＇ strong positive result of the direct antiglobulin test was 1.46% （3/205）, unknown causes was 5.37%（11/205）. 157 cases with blood group antibody, in which 29 cases 18.47%（29/157） with blood group antibody cannot be identified, and failed to determine the blood group system, 128 cases of blood type antibody system involving the ABO, Rh, MNSs, Lewis, Duffy and Kidd blood group system , Rh blood group antibody was 75.16%（118/157）, the majority antibodies of Rh blood group system was anti-E 85.59%（101/118）and antic 24.58%（29/118）. Conclusion The reasons of the unmatched major cross-matching test was antoantibody and unregular antibody. And related to Rh blood group antibody, especially anti E and anti C.